Objectives: To compare population-based prevalence estimates of sexual risk behaviours and HIV seroprevalence of male sex workers who have sex with men (MSM) and those not engaged in sex work in Campinas, Brazil.
Methods: MSM (n = 658) were recruited for a cross-sectional study through respondent-driven sampling. Audio-assisted computer self-interview was used to collect information on sexual behaviours and HIV testing (optional) was performed. Population-based prevalence estimates with 95% CI of characteristics and behaviours of MSM sex workers and non-sex workers are reported.
Results: One-quarter reported ever receiving payment for sex and 14.8% (95% CI 11.1 to 19.0) had been paid in the previous 2 months; most exclusively with men. MSM sex workers were significantly more likely than non-sex workers to report being transgendered (40.5% vs 8.1%), to practise unprotected receptive (22.4% vs 4.6%) and insertive (20.5% vs 5.0%) anal intercourse with ⩾2 male partners and to have unprotected vaginal sex with women (22.7% vs 5.6%). MSM sex workers experienced significantly greater rates of psychological abuse (80.9% vs 58.4%) and physical abuse (48.2% vs 15.2%).
Conclusions: MSM sex workers have higher sexual risk behaviours as well as social vulnerabilities than the general population of MSM. HIV/sexually transmitted infection prevention efforts should be targeted to this riskier subgroup. Programmes should be transgender sensitive, should recognise that MSM sex workers have sex with men and women and address other factors that influence risk, such as homophobic abuse.
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Funding: This study was supported by the President’s Emergency Plan for AIDS Relief and the generous support of the American people through the United States Agency for International Development (USAID) through the Population Council’s Horizons Program under the terms of cooperative agreement no HRN-A-00-97-00012-00. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the United States government.
Competing interests: None.
Ethics approval: The study was approved by the Population Council Institutional Review Board, the State University of Campinas Ethics Committee and Comissão Nacional de Ética em Pesquisa/Brazil.
Contributors: MdM and JD led the conception and design of the research study. AP and MdM oversaw the operations of the field data collection. MC, AP, WT, MdM and JD conducted the analysis and participated in the data interpretation. WT participated in the protocol development and was the main author responsible for the writing and final editing of the manuscript. All authors approved the final version of the submitted manuscript.
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